Respiratory medicine
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Respiratory medicine · Nov 2009
Case ReportsSevere acute fibrinous and organizing pneumonia (AFOP) causing ventilatory failure: successful treatment with mycophenolate mofetil and corticosteroids.
Acute fibrinous and organizing pneumonia (AFOP) has recently been identified as an unusual variant of acute lung injury. We describe a man with rapidly progressive lung disease who had AFOP detected via surgical lung biopsy. ⋯ He responded poorly to initial treatment and progressively worsened, but he subsequently responded very well to combined therapy with mycophenolate mofetil and methylprednisolone. The combination of corticosteroids and mycophenolate may provide a safe and effective treatment strategy for severe forms of this newly defined pulmonary syndrome.
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Respiratory medicine · Nov 2009
Multicenter Study"Real-life" effectiveness of omalizumab in patients with severe persistent allergic asthma: The PERSIST study.
To evaluate the 16- and 52-week effectiveness of add-on omalizumab treatment under real-life heterogeneity in patients, settings, and physicians in an open-label, multicenter, pharmaco-epidemiologic study of patients with severe persistent allergic asthma in Belgium. ⋯ The PERSIST study shows better physician-rated effectiveness, greater improvements in quality of life, greater reductions in exacerbation rates, and greater reductions in healthcare utilization than previously reported in efficacy studies. Under real-life conditions, omalizumab is effective as add-on therapy in the treatment of patients with persistent severe allergic asthma.
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Respiratory medicine · Nov 2009
Comparative StudyRespiratory muscle unloading during auto-adaptive non-invasive ventilation.
Non-invasive ventilation (NIV) has been shown to improve clinical outcomes in acute and chronic hypercapnic respiratory failure. A new timed, automated, auto-adaptive non-invasive ventilatory mode (TA-mode) has been recently introduced. ⋯ TA-mode-NIV achieved significant higher levels of respiratory muscle unloading in healthy individuals when compared to assisted non-invasive ventilation.
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Respiratory medicine · Nov 2009
Outcome of pulmonary hypertension subjects transitioned from intravenous prostacyclin to oral bosentan.
Prostacyclin (PG) remains the gold standard therapy for severe pulmonary arterial hypertension (PAH). Previously, we reported the successful transitioning of PAH subjects from intravenous prostacyclin to oral bosentan (Suleman et al. Chest 2004;126:808-15). We report here the 5-year follow-up data. ⋯ In this study, patients frequently required prostanoid resumption after transition from intravenous prostanoid to oral therapy. However, in these carefully selected patients, transition to oral therapy offered prolonged stable FC and 6MWD, cost savings and substantial quality of life benefits.